help with vit D levels

I started out on the low end of normal range -- around 30 following my diagnosis. I started supplementing with D3 drops (dropped the D2 quickly, since I read about how it doesn't do much) by Carlsons.  I took those for about 4 months, got re-tested and my levels went up to 70.  I stopped taking the D drops this summer since I was out in the sun so much, and was curious to see if my body would maintain that level. I got my results back yesterday, and I dropped down to 58.  I started supplementing again this week.  I figure if I supplement in the winter months, I should be able to sustain a good average amount of Vit D in my bloodstream.   I had a slightly overactive parathyroid, and my endo suggested that it would even out if I started taking Vitamin D.... and it did exactly that. My PTH went right into the normal range and has stayed there since I started to supplement.

Jazz: actually excess Vitamin D is not elimintated by the body. Vitamin D is fat soluble, so any excess is stored by the body. The same is true of all fat-soluble vitamins (A, D, E, K) so excesses of these can be toxic.

If you take more than you need of the water soluble vitamins (B complex and C) then you eliminate the excess in your urine. This is why it's important to get adequate Vitamin C on a daily basis.

Day ....yes, the trial was quite a large one; but there is no mention of measures of bone density - only that there was no significant difference between the two groups in terms of 'skeletal fractures'. Not the same thing. I have osteoporosis, but have not suffered a skeletal fracture (hopefully never). So I don't see how it can be extrapolated that aromasin does not cause loss of bone density.

Sorry, Day - by following your link all I can see is one page (on NEJM) and no tables...??

This is extremely important to me now, as my doc will likely suggest an AI because of my chemopause at age 40.

I don't see a table 4, could someone point that out?  Day?  Many thanks.

Additionally, the median age is 62.5.  That seems a bit on the older side.  Bone density loss is most acute in the 3 years post-menopause.  Tamoxifen functions as a bone LOSS drug in pre-meno patients, point being, these drugs work differently depending on age.  I think this study would have less relevance to younger patients.  I could be wrong and want to know more.

Wonderful, Day, thank you for reposting!  I appreciate your time so much!

Actually, we wouldn't really know if it has relevance for young patients, in part, that's my point.  They are learning these hormone modulators are quite nuanced.  Why Tamoxifen is a bone loss drug in pre menopausal patients, and a bone builder in post is not understood.  I doubt they've even considered tests on AIs in women thrown into chemopause, or those who chose Lupron suppression, for instance.

I simply think there is going to be a ton more work on all these drugs in the upcoming years.  Unfortunately, I don't think solid answers will arise.  In the meantime, it is comforting that AIs may not mean rapid bone loss.

I have no idea why. If I copy that link, and paste it in the browser, it works. It doesn't work clicking on it though.

Sorry I sent you to the wrong page, chemo brain still jumps onboard sometimes.

Actually that is not how you calculate, and I apologize, but you have it wrong. The 25% is far from reality. You can actually see the percentage there, it's 1,7% (the number in paranthesis after each number is the percentage)

Out of the 2240 patients that took exemestane, 37 got new osteoporosis. That is 1,7%. 

Out of 2248 patients who took placebo, 30 got new osteoporosis. That is 1.3%.

The difference is 0.4% Considering that the life style and diet were not taken into consideration, this percentage practically makes doctors safely say that there is no significant bone loss caused by Exemestane.

 You can see that the only areas where there is a significant difference are sweating and joint pain, with a 3% more women who took exemestane having the symptoms compared to those taking placebo.

As for the difference in recurrence rate, that speaks for itself.

I think it is because there werent' many studies of this magnitude. This one was started in 2005.

We also know  that for the time being there is no study concluded yet regarding the efficiency of 5 years of Tamoxifen followed by 5 years of AI compared to AI alone for post-menopausal women. There is no study yet concluded about using AI's for more than 5 years.

As for the previous studies concerning AIs and bone loss.... someone mentioned the fact that the study was done using patients with a median age of 62.

Considering the fact that there is no study done yet for pre-menopausal women who were pushed into menopause by chemo/Lupron/oophorectomy right before the started the AI's, and the results this study shows us, and knowing the fact that most bone loss occurs in the first 5 years after menopause, to me it stands to logic that it's not the AI's that cause the bone loss in this case - it's just the menopause.

Hi JO, just thought about you earlier today.  Glad to see you are checking in occasionally.  I've actually been on 3000-5000 IU's fo D3 for at least 8 months and my recent test came in at 42 which is only about 10 points above where I placed last year.  Seems the numbers go up quicker for some people than others.  I will stay on 4000-5000 and test again in February when I go back to my MO.

Thanks everyone for all the sites listed in the messages.  My Vitamin D was 9.  I Was on 50,000 units a day for a few weeks now am on about 3,000 units of Vitamin D and Calcium a day.  Perhaps one of the papers will mention this mess I am in.Thanks again.

Day, yes, I need to be more on top of taking the Calcium regularly.  I was getting cramps and stopped taking lots of things to try and track the cause and just never got back to taking the Calcium regularly.  It's also why I had dropped to only about 3000 iu's of D3 as I thought maybe the higher dose (5000-6000 iu's) was part of the cramping. 

I'm new to this thread and playing catchup. This might already be here, but can anyone point me to studies that show benefits of having Vit D blood level >20?

I saw a bone endocrinologist last week and he said 20 is the minimum but for bone health in healthy patients, there's no evidence that higher numbers are better (though I see some posts here that some specific conditions/symptoms might warrant a higher vit D level, so that might be a different situation).

This doc also said there is no known toxicity at 3000-4000 IU/day max (including food and sun) but that larger doses can cause problems. We dis-recommended taking some of the mega-dose pills on the market. Again, your doc might have recommended a different dose for a short-term specific reason but just an FYI on another doc's opinion. BTW, I posted other notes in the Bones forum.

Have not been on this thread in awhile.  In Feb my D was 42, in March was 47 in July was 57 and now in Oct it is down to 44.  I started 2,000IUs of D3 in Feb.  MO wants it up to 65.  What foods are high in Vit D? Think I will double my D3 to see if it helps as well.  Any suggestions.  I do walk outside several times a week for 3 miles.

JO, that's why I'm not married - probably end up in jail for murder of a man that practiced so many bad things and still stayed healthier than me!!!  At least introduce him to the legs of an ironing board.  (for those who are scratching their head, it's a private joke between me and my 'twin', JO)  BTW JO, how many "last show' is this for you now?    Okay, I'll stop picking on you.